Provider Demographics
NPI:1982588786
Name:SANDERSON, VICTORIA MORGAN
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:MORGAN
Last Name:SANDERSON
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 TAPP FARM RD
Mailing Address - Street 2:
Mailing Address - City:PINK HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28572-7928
Mailing Address - Country:US
Mailing Address - Phone:252-560-7940
Mailing Address - Fax:
Practice Address - Street 1:325 NC-55 WEST
Practice Address - Street 2:
Practice Address - City:MOUNT OLIVE
Practice Address - State:NC
Practice Address - Zip Code:28365-1203
Practice Address - Country:US
Practice Address - Phone:919-658-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5022718363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily